Pub Date : 2024-11-05DOI: 10.1016/j.glmedi.2024.100152
Khurram Khaliq Bhinder, Atif Iqbal Rana, Haider Ali, Zahid Amin Khan, Jamshaid Anwar, Ahmad Ammar Afzal, Maria Rauf
Pulmonary pseudoaneurysms (PAPs) are potentially life-threatening entity. Pulmonary pseudoaneurysm (PAP) post-COVID-19 infection is a rare complication with only a few case reports. Here, we describe two such patients who were successfully treated with embolization using pushable coils. Our first patient was a 72-year-old male who presented with massive hemoptysis two months after COVID-19 pneumonia. CT tomography angiography showed a thick-walled cavitary lesion with a bilobed pseudoaneurysm arising from the posterior segmental branch of the right lower lobe pulmonary artery. In our second case, a 66-year-old female presented with hemoptysis two month after COVID-19 infection. Chest CT showed extensive pulmonary opacities. This patient also had a pseudoaneurysm of the posterior segmental branch of the right lower lobe pulmonary artery. Both patients were treated with embolization using pushable coils to achieve occlusion of the pseudoaneurysm and its feeding artery.
{"title":"Treatment of post COVID-19 pulmonary artery pseudoaneurysm: a report of two cases","authors":"Khurram Khaliq Bhinder, Atif Iqbal Rana, Haider Ali, Zahid Amin Khan, Jamshaid Anwar, Ahmad Ammar Afzal, Maria Rauf","doi":"10.1016/j.glmedi.2024.100152","DOIUrl":"10.1016/j.glmedi.2024.100152","url":null,"abstract":"<div><div>Pulmonary pseudoaneurysms (PAPs) are potentially life-threatening entity. Pulmonary pseudoaneurysm (PAP) post-COVID-19 infection is a rare complication with only a few case reports. Here, we describe two such patients who were successfully treated with embolization using pushable coils. Our first patient was a 72-year-old male who presented with massive hemoptysis two months after COVID-19 pneumonia. CT tomography angiography showed a thick-walled cavitary lesion with a bilobed pseudoaneurysm arising from the posterior segmental branch of the right lower lobe pulmonary artery. In our second case, a 66-year-old female presented with hemoptysis two month after COVID-19 infection. Chest CT showed extensive pulmonary opacities. This patient also had a pseudoaneurysm of the posterior segmental branch of the right lower lobe pulmonary artery. Both patients were treated with embolization using pushable coils to achieve occlusion of the pseudoaneurysm and its feeding artery.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1016/j.glmedi.2024.100150
Hassan Karami , Mina Soleimani, Negar Nayerain Jazi, Kiana Navi, Rojina Sajadi, Mohammad Mehdi Fazeli, Golara Pagheh, Samane Ostadhadi Dehkordi
The global emergence of several major viral disease outbreaks over the last two decades represents how infectious diseases alarmingly threaten human health despite significant progress in medical advances in recent years. Therefore, it is essential to address the threat of the next viral pandemic and draw global attention to invest in research, development, and implementation of risk-reduction interventions to harness the benefits of preparedness plans aimed at minimizing the potential spread of viruses to previously affected and even unaffected regions of the world and reducing the burden of future global outbreaks. Here, we discuss six pillars of preparedness including enhancing monitoring and surveillance capabilities, developing diagnostic tools, building a robust and well-resourced healthcare system, developing effective medical countermeasures (Vaccines and treatments), and improving collaboration and financial support at both local and global levels. This letter calls for global preparedness to ensure an effective, timely, and coordinated response to future viral threats with significant importance to public health.
{"title":"The next viral pandemic: A call for global preparedness","authors":"Hassan Karami , Mina Soleimani, Negar Nayerain Jazi, Kiana Navi, Rojina Sajadi, Mohammad Mehdi Fazeli, Golara Pagheh, Samane Ostadhadi Dehkordi","doi":"10.1016/j.glmedi.2024.100150","DOIUrl":"10.1016/j.glmedi.2024.100150","url":null,"abstract":"<div><div>The global emergence of several major viral disease outbreaks over the last two decades represents how infectious diseases alarmingly threaten human health despite significant progress in medical advances in recent years. Therefore, it is essential to address the threat of the next viral pandemic and draw global attention to invest in research, development, and implementation of risk-reduction interventions to harness the benefits of preparedness plans aimed at minimizing the potential spread of viruses to previously affected and even unaffected regions of the world and reducing the burden of future global outbreaks. Here, we discuss six pillars of preparedness including enhancing monitoring and surveillance capabilities, developing diagnostic tools, building a robust and well-resourced healthcare system, developing effective medical countermeasures (Vaccines and treatments), and improving collaboration and financial support at both local and global levels. This letter calls for global preparedness to ensure an effective, timely, and coordinated response to future viral threats with significant importance to public health.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1016/j.glmedi.2024.100151
Tasneem Alomari, Omar Alomari , Russel J. Reiter
Melatonin, traditionally known for its role in sleep regulation, is emerging as a significant therapeutic agent in dental practice due to its antibacterial, antiviral, anti-inflammatory, and antioxidant properties. Present in saliva and locally secreted in the oral cavity, melatonin can protect gingival and periodontal tissues by reducing inflammation and oxidative damage. Additionally, it influences enamel maturation and has implications for systemic conditions such as diabetes, highlighting its relevance in dentistry. We propose integrating melatonin into oral healthcare practices by assessing patients' melatonin use, particularly those with inflammatory or systemic conditions, and recommending melatonin-based treatments like sublingual tablets or topical gels to enhance periodontal treatment, promote tissue repair, and reduce oral mucosal lesions. Public health initiatives should raise awareness of melatonin's preventive potential for high-risk populations, and policy frameworks should consider these findings in oral health guidelines. Rigorous clinical studies are essential to establish a solid empirical foundation for melatonin's protective effects on oral health outcomes, necessitating standardized clinical research to validate these preliminary findings.
{"title":"The impact of melatonin on oral health: Current insights and future research directions","authors":"Tasneem Alomari, Omar Alomari , Russel J. Reiter","doi":"10.1016/j.glmedi.2024.100151","DOIUrl":"10.1016/j.glmedi.2024.100151","url":null,"abstract":"<div><div>Melatonin, traditionally known for its role in sleep regulation, is emerging as a significant therapeutic agent in dental practice due to its antibacterial, antiviral, anti-inflammatory, and antioxidant properties. Present in saliva and locally secreted in the oral cavity, melatonin can protect gingival and periodontal tissues by reducing inflammation and oxidative damage. Additionally, it influences enamel maturation and has implications for systemic conditions such as diabetes, highlighting its relevance in dentistry. We propose integrating melatonin into oral healthcare practices by assessing patients' melatonin use, particularly those with inflammatory or systemic conditions, and recommending melatonin-based treatments like sublingual tablets or topical gels to enhance periodontal treatment, promote tissue repair, and reduce oral mucosal lesions. Public health initiatives should raise awareness of melatonin's preventive potential for high-risk populations, and policy frameworks should consider these findings in oral health guidelines. Rigorous clinical studies are essential to establish a solid empirical foundation for melatonin's protective effects on oral health outcomes, necessitating standardized clinical research to validate these preliminary findings.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1016/j.glmedi.2024.100144
Ameer Awashra , Fathi Milhem , Amr Khaled , Roaa Hamshari , Noor Nabresi , Ola Ahmad , Asad Rabee
Autoimmune encephalitis (AE) is a rapidly progressing inflammatory brain disease often characterized by psychiatric symptoms, seizures, and cognitive impairments. This case involves a 13-year-old female who initially presented with a persistent, severe unilateral headache unresponsive to standard treatments. Despite normal imaging and neurological exams, her symptoms escalated to include neuropsychiatric issues, eventually leading to the diagnosis of AE, confirmed through the presence of NMDA receptor antibodies. Treatment with immunomodulatory therapies, including intravenous methylprednisolone and plasmapheresis, resulted in significant clinical improvement over several months. The case highlights the complexities and challenges in diagnosing AE, especially in instances where imaging findings are unremarkable or the presentation is atypical, resulting in multiple misdiagnoses.
{"title":"Atypical presentation of autoimmune encephalitis in a pediatric patient: Diagnostic delays and treatment responses","authors":"Ameer Awashra , Fathi Milhem , Amr Khaled , Roaa Hamshari , Noor Nabresi , Ola Ahmad , Asad Rabee","doi":"10.1016/j.glmedi.2024.100144","DOIUrl":"10.1016/j.glmedi.2024.100144","url":null,"abstract":"<div><div>Autoimmune encephalitis (AE) is a rapidly progressing inflammatory brain disease often characterized by psychiatric symptoms, seizures, and cognitive impairments. This case involves a 13-year-old female who initially presented with a persistent, severe unilateral headache unresponsive to standard treatments. Despite normal imaging and neurological exams, her symptoms escalated to include neuropsychiatric issues, eventually leading to the diagnosis of AE, confirmed through the presence of NMDA receptor antibodies. Treatment with immunomodulatory therapies, including intravenous methylprednisolone and plasmapheresis, resulted in significant clinical improvement over several months. The case highlights the complexities and challenges in diagnosing AE, especially in instances where imaging findings are unremarkable or the presentation is atypical, resulting in multiple misdiagnoses.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-20DOI: 10.1016/j.glmedi.2024.100143
Mina Attin , Jie Ren , Chad Cross , Sidath Kapukotuwa , Ryan Shao , Peter G. Kaufmann , C.D. (Joey) Lin , Kim Arcoleo
<div><div>In-hospital cardiac arrest (IHCA) has been understudied relative to out-of-hospital cardiac arrest. Further, studies of IHCA have mainly focused on a limited number of pre-arrest patient characteristics (e.g., demographics, number and types of comorbidities). Arterial blood gas (ABG) analysis, one of the most common diagnostic tests for assessing and managing critically or acutely ill hospitalized patients, reflects pathophysiological changes associated with adverse events or complications, including IHCA. Yet the predictive and prognostic values of patterns of pre-arrest ABG parameters for IHCA have not been fully studied. The purpose of this retrospective pilot cohort study was to investigate temporal variations in and predictive values of pre-IHCA ABG values among patients with a history of cardiopulmonary diseases. Eligible patients had a history of structural heart disease, heart failure, or pulmonary diseases. Patients were excluded if their IHCA was due to trauma, drug overdose, hypothermia, drowning, chronic terminal illness such as cancer or human immunodeficiency virus, or bleeding not caused by hemorrhage in the brain or heart. Also collected were dates, times, and causes of mechanical intubation prior to IHCA and causes of mortality. Co-primary outcomes were initial rhythms of IHCA and return of spontaneous circulation (ROSC). We conducted a pilot study and the ABG results (pH, partial pressure of carbon dioxide [PaCO<sub>2</sub>], partial pressure of oxygen [PaO<sub>2</sub>], bicarbonate [HCO<sub>3</sub><sup>-</sup>] , and lactate) from each of the 3 days prior to IHCA were extracted from the electronic health records (EHRs) of patients (N = 44) who had experienced IHCA at a single medical center. To characterize differences in ABG parameters among study days, coefficients of variation (CVs) were compared using the modified likelihood ratio test (MLRT) using the worst ABG values. Linear regression models were run for the continuous ABG parameters and logistic regression models for the dichotomous ABG variables. Overall model effect and least squares means, SDs, mean differences within and between days (with 95 % confidence intervals), <em>p</em>-values and effect sizes were reported for continuous variables. For categorical variables, estimates and standard errors, 95 % confidence intervals, Wald X2 variables and <em>p</em>-values were presented. The CVs for pH, PaCO<sub>2</sub>, and HCO<sub>3</sub><sup>-</sup> differed significant between study days (<em>p</em> <.05). The least squares means with 95 % confidence intervals for pH and lactate differed significantly in days (<em>p</em> <.01). Moderate to large effect sizes were obtained for all ABG parameters. Arterial lactate predicted initial rhythm (shockable versus non-shockable) and ROSC, while pH and HCO<sub>3</sub><sup>-</sup> predicted ROSC. Results demonstrate, for the first time, the presence of significant variability in ABG parameters across 72 h prior to IH
{"title":"Temporal variations in and predictive values of ABG results prior to in-hospital cardiac arrest","authors":"Mina Attin , Jie Ren , Chad Cross , Sidath Kapukotuwa , Ryan Shao , Peter G. Kaufmann , C.D. (Joey) Lin , Kim Arcoleo","doi":"10.1016/j.glmedi.2024.100143","DOIUrl":"10.1016/j.glmedi.2024.100143","url":null,"abstract":"<div><div>In-hospital cardiac arrest (IHCA) has been understudied relative to out-of-hospital cardiac arrest. Further, studies of IHCA have mainly focused on a limited number of pre-arrest patient characteristics (e.g., demographics, number and types of comorbidities). Arterial blood gas (ABG) analysis, one of the most common diagnostic tests for assessing and managing critically or acutely ill hospitalized patients, reflects pathophysiological changes associated with adverse events or complications, including IHCA. Yet the predictive and prognostic values of patterns of pre-arrest ABG parameters for IHCA have not been fully studied. The purpose of this retrospective pilot cohort study was to investigate temporal variations in and predictive values of pre-IHCA ABG values among patients with a history of cardiopulmonary diseases. Eligible patients had a history of structural heart disease, heart failure, or pulmonary diseases. Patients were excluded if their IHCA was due to trauma, drug overdose, hypothermia, drowning, chronic terminal illness such as cancer or human immunodeficiency virus, or bleeding not caused by hemorrhage in the brain or heart. Also collected were dates, times, and causes of mechanical intubation prior to IHCA and causes of mortality. Co-primary outcomes were initial rhythms of IHCA and return of spontaneous circulation (ROSC). We conducted a pilot study and the ABG results (pH, partial pressure of carbon dioxide [PaCO<sub>2</sub>], partial pressure of oxygen [PaO<sub>2</sub>], bicarbonate [HCO<sub>3</sub><sup>-</sup>] , and lactate) from each of the 3 days prior to IHCA were extracted from the electronic health records (EHRs) of patients (N = 44) who had experienced IHCA at a single medical center. To characterize differences in ABG parameters among study days, coefficients of variation (CVs) were compared using the modified likelihood ratio test (MLRT) using the worst ABG values. Linear regression models were run for the continuous ABG parameters and logistic regression models for the dichotomous ABG variables. Overall model effect and least squares means, SDs, mean differences within and between days (with 95 % confidence intervals), <em>p</em>-values and effect sizes were reported for continuous variables. For categorical variables, estimates and standard errors, 95 % confidence intervals, Wald X2 variables and <em>p</em>-values were presented. The CVs for pH, PaCO<sub>2</sub>, and HCO<sub>3</sub><sup>-</sup> differed significant between study days (<em>p</em> <.05). The least squares means with 95 % confidence intervals for pH and lactate differed significantly in days (<em>p</em> <.01). Moderate to large effect sizes were obtained for all ABG parameters. Arterial lactate predicted initial rhythm (shockable versus non-shockable) and ROSC, while pH and HCO<sub>3</sub><sup>-</sup> predicted ROSC. Results demonstrate, for the first time, the presence of significant variability in ABG parameters across 72 h prior to IH","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.glmedi.2024.100148
Usamah Al-Anbagi , Abdulrahman Saad , Tarek Ibrahim , Abdulqadir J. Nashwan
Epiploic appendagitis is a rare, self-limiting inflammatory condition affecting the epiploic appendages, which often mimics other acute abdominal conditions such as appendicitis or diverticulitis, creating a diagnostic challenge for healthcare providers. In this case, a 37-year-old male presented with sharp, non-radiating right lower quadrant abdominal pain lasting two days, accompanied by nausea. Upon physical examination, localized tenderness was noted without signs of rebound or guarding. A contrast-enhanced CT scan revealed a 2.5 cm ovoid lesion with fatty stranding on the cecum wall, along with adjacent reactive lymph nodes, confirming the diagnosis of epiploic appendagitis. Given its rarity, this condition should be included in the differential diagnosis for acute abdominal pain, as accurate diagnosis through appropriate imaging can prevent unnecessary surgical interventions and ensure effective management.
{"title":"Epiploic appendagitis: A case report and review of diagnostic challenges","authors":"Usamah Al-Anbagi , Abdulrahman Saad , Tarek Ibrahim , Abdulqadir J. Nashwan","doi":"10.1016/j.glmedi.2024.100148","DOIUrl":"10.1016/j.glmedi.2024.100148","url":null,"abstract":"<div><div>Epiploic appendagitis is a rare, self-limiting inflammatory condition affecting the epiploic appendages, which often mimics other acute abdominal conditions such as appendicitis or diverticulitis, creating a diagnostic challenge for healthcare providers. In this case, a 37-year-old male presented with sharp, non-radiating right lower quadrant abdominal pain lasting two days, accompanied by nausea. Upon physical examination, localized tenderness was noted without signs of rebound or guarding. A contrast-enhanced CT scan revealed a 2.5 cm ovoid lesion with fatty stranding on the cecum wall, along with adjacent reactive lymph nodes, confirming the diagnosis of epiploic appendagitis. Given its rarity, this condition should be included in the differential diagnosis for acute abdominal pain, as accurate diagnosis through appropriate imaging can prevent unnecessary surgical interventions and ensure effective management.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.glmedi.2024.100145
Muhammad Nawaz Khan , Muniba Fatima , Muhammad Mubashir , Syed Muhammad Sinaan Ali
We present a rare case of autoimmune brainstem encephalitis, a serious inflammatory condition affecting the brainstem, in a 20-year-old female simultaneously with systemic lupus erythematosus (SLE). Brainstem encephalitis can be caused by various infectious diseases, autoimmune disorders, and paraneoplastic syndromes. When associated with autoimmune disorders, its diagnosis and management can be challenging.Symptoms typically include those of the underlying autoimmune disorder, along with features of encephalitis such as headache, altered consciousness, fever, seizures, and cranial nerve involvement. Our patient presented with fever, seizures, and signs indicative of SLE, which were later confirmed through various antibody profiles. The patient was treated with steroids and immunosuppressants, showing a positive response, and was eventually discharged. This case highlights the diagnostic challenges and treatment approaches employed to manage symptoms and address the disease. Autoimmune brainstem encephalitis caused by SLE is a rare but potentially morbid condition, often diagnosed late. Looking out for specific signs and symptoms leads to prompt diagnosis and timely management. SLE encephalitis is rarely reported and poorly understood.Therefore, further research is required.
{"title":"A case report of brainstem encephalitis associated with systemic lupus erythematosus in a young female","authors":"Muhammad Nawaz Khan , Muniba Fatima , Muhammad Mubashir , Syed Muhammad Sinaan Ali","doi":"10.1016/j.glmedi.2024.100145","DOIUrl":"10.1016/j.glmedi.2024.100145","url":null,"abstract":"<div><div>We present a rare case of autoimmune brainstem encephalitis, a serious inflammatory condition affecting the brainstem, in a 20-year-old female simultaneously with systemic lupus erythematosus (SLE). Brainstem encephalitis can be caused by various infectious diseases, autoimmune disorders, and paraneoplastic syndromes. When associated with autoimmune disorders, its diagnosis and management can be challenging.Symptoms typically include those of the underlying autoimmune disorder, along with features of encephalitis such as headache, altered consciousness, fever, seizures, and cranial nerve involvement. Our patient presented with fever, seizures, and signs indicative of SLE, which were later confirmed through various antibody profiles. The patient was treated with steroids and immunosuppressants, showing a positive response, and was eventually discharged. This case highlights the diagnostic challenges and treatment approaches employed to manage symptoms and address the disease. Autoimmune brainstem encephalitis caused by SLE is a rare but potentially morbid condition, often diagnosed late. Looking out for specific signs and symptoms leads to prompt diagnosis and timely management. SLE encephalitis is rarely reported and poorly understood.Therefore, further research is required.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.glmedi.2024.100146
Najib Bahrou , El Khalil Cherif , Safa Elmouhib , Jihane EL Hamzaoui , Yahia ZaineAl Abidine Khedid , Mohamed El Absi , El Mahjoub Echarrab , Mohamed El Ounani , EL Alami El Faricha El Hassan
Fecaloma, an accumulation of hardened fecal matter, is a clinical challenge that most often occurs in the rectum and sigmoid colon, rarely in the rest of the colon. Often overlooked, fecalomas can potentially lead to serious complications such as obstruction and perforation. Conservative management of fecaloma typically involves the use of laxatives, enemas, or digital disimpaction. However, when conservative methods are ineffective surgical intervention is required. This article presents a rare case of a 54-year-old patient with a history of tuberculous meningoradiculitis and chronic constipation, leading to a giant fecaloma presenting with severe abdominal distension. Despite conservative measures, including enemas and dietary care, the patient developed stercoral peritonitis and sigmoid colonic perforation necessitating late surgical intervention leading to death. This case allows us to engage in discussions over the correct management of this entity which is often underestimated by healthcare practitioners particularly by surgeons.
{"title":"Giant fecaloma: Can early surgical intervention prevent stercoral peritonitis?","authors":"Najib Bahrou , El Khalil Cherif , Safa Elmouhib , Jihane EL Hamzaoui , Yahia ZaineAl Abidine Khedid , Mohamed El Absi , El Mahjoub Echarrab , Mohamed El Ounani , EL Alami El Faricha El Hassan","doi":"10.1016/j.glmedi.2024.100146","DOIUrl":"10.1016/j.glmedi.2024.100146","url":null,"abstract":"<div><div>Fecaloma, an accumulation of hardened fecal matter, is a clinical challenge that most often occurs in the rectum and sigmoid colon, rarely in the rest of the colon. Often overlooked, fecalomas can potentially lead to serious complications such as obstruction and perforation. Conservative management of fecaloma typically involves the use of laxatives, enemas, or digital disimpaction. However, when conservative methods are ineffective surgical intervention is required. This article presents a rare case of a 54-year-old patient with a history of tuberculous meningoradiculitis and chronic constipation, leading to a giant fecaloma presenting with severe abdominal distension. Despite conservative measures, including enemas and dietary care, the patient developed stercoral peritonitis and sigmoid colonic perforation necessitating late surgical intervention leading to death. This case allows us to engage in discussions over the correct management of this entity which is often underestimated by healthcare practitioners particularly by surgeons.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Quetiapine is an atypical antipsychotic commonly used to manage psychotic and bipolar disorders. While quetiapine overdose is often associated with sedation, tachycardia, and QT interval prolongation on the ECG, severe hypotension and corrected QT interval (QTc) prolongation are relatively rare. There is limited information available regarding the safety of quetiapine overdose, particularly in the pediatric population. Here, we present the case of a 15-year-old girl who ingested quetiapine in a suicide attempt. A 15-year-old girl who ingested 1200 mg of quetiapine (22.6 mg/kg) in a suicide attempt. The overdose led to multiple severe symptoms, including tachycardia, agitation, hypotension, loss of consciousness, and QTc prolongation. To effectively eliminate quetiapine, we utilized a combination of hemoperfusion (HP) and continuous venovenous hemodiafiltration (CVVHDF) therapy. According to recent literature, this is the first reported pediatric case of severe quetiapine poisoning successfully treated with the combined use of HP and CVVHDF. In this report, we compare the clinical presentation with previous cases of quetiapine overdose in both pediatric and adult populations, review current treatment recommendations, and introduce a novel therapeutic approach for managing quetiapine poisoning.
{"title":"A case report of combined hemoperfusion and hemodiafiltration utilization in pediatric severe Quetiapine poisoning","authors":"Ufuk Yükselmiş , Merve Akçay , Omar Alomari , Müge Kömürcüoğlu Yılmaz","doi":"10.1016/j.glmedi.2024.100147","DOIUrl":"10.1016/j.glmedi.2024.100147","url":null,"abstract":"<div><div>Quetiapine is an atypical antipsychotic commonly used to manage psychotic and bipolar disorders. While quetiapine overdose is often associated with sedation, tachycardia, and QT interval prolongation on the ECG, severe hypotension and corrected QT interval (QTc) prolongation are relatively rare. There is limited information available regarding the safety of quetiapine overdose, particularly in the pediatric population. Here, we present the case of a 15-year-old girl who ingested quetiapine in a suicide attempt. A 15-year-old girl who ingested 1200 mg of quetiapine (22.6 mg/kg) in a suicide attempt. The overdose led to multiple severe symptoms, including tachycardia, agitation, hypotension, loss of consciousness, and QTc prolongation. To effectively eliminate quetiapine, we utilized a combination of hemoperfusion (HP) and continuous venovenous hemodiafiltration (CVVHDF) therapy. According to recent literature, this is the first reported pediatric case of severe quetiapine poisoning successfully treated with the combined use of HP and CVVHDF. In this report, we compare the clinical presentation with previous cases of quetiapine overdose in both pediatric and adult populations, review current treatment recommendations, and introduce a novel therapeutic approach for managing quetiapine poisoning.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"4 ","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.glmedi.2024.100149
Najim Z. Alshahrani
In the digital age, social media influencers (SMIs) have emerged as a significant force in altering public attitudes and behaviors, notably in the health sector. While SMIs can provide useful insights on crucial health issues such as diet and mental health, they also raise concerns about their varying levels of health competence and potential commercial biases. This dichotomy poses a challenge: can SMIs effectively contribute to better health outcomes, or do they risk encouraging harmful behavior? This letter investigates this dynamic by synthesizing findings from three cross-sectional studies undertaken in Saudi Arabia, with the goal of providing policymakers with actionable insights on how to improve public health while navigating the inherent risks.
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